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Clemente T, Canetti D, Messina E, Carini E, Della Torre L, Papaioannu Borjesson R, Castagna A, Spagnuolo V. Long-term outcome in a person with pandrug-resistant HIV: the added value of a multidisciplinary approach. JAC Antimicrob Resist 2024; 6:dlae074. [PMID: 38756960 PMCID: PMC11098035 DOI: 10.1093/jacamr/dlae074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Affiliation(s)
- Tommaso Clemente
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona, 20, 20127 Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Diana Canetti
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona, 20, 20127 Milan, Italy
| | - Emanuela Messina
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona, 20, 20127 Milan, Italy
| | - Elisabetta Carini
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona, 20, 20127 Milan, Italy
| | - Liviana Della Torre
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona, 20, 20127 Milan, Italy
| | - Rebecka Papaioannu Borjesson
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona, 20, 20127 Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Antonella Castagna
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona, 20, 20127 Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Vincenzo Spagnuolo
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona, 20, 20127 Milan, Italy
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2
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Dettori M, Riccardi N, Canetti D, Antonello RM, Piana AF, Palmieri A, Castiglia P, Azara AA, Masia MD, Porcu A, Ginesu GC, Cossu ML, Conti M, Pirina P, Fois A, Maida I, Madeddu G, Babudieri S, Saderi L, Sotgiu G. Infections in lung transplanted patients: A review. Pulmonology 2024; 30:287-304. [PMID: 35710714 DOI: 10.1016/j.pulmoe.2022.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 03/29/2022] [Accepted: 04/25/2022] [Indexed: 02/07/2023] Open
Abstract
Lung transplantation can improve the survival of patients with severe chronic pulmonary disorders. However, the short- and long-term risk of infections can increase morbidity and mortality rates. A non-systematic review was performed to provide the most updated information on pathogen, host, and environment-related factors associated with the occurrence of bacterial, fungal, and viral infections as well as the most appropriate therapeutic options. Bacterial infections account for about 50% of all infectious diseases in lung transplanted patients, while viruses represent the second cause of infection accounting for one third of all infections. Almost 10% of patients develop invasive fungal infections during the first year after lung transplant. Pre-transplantation comorbidities, disruption of physical barriers during the surgery, and exposure to nosocomial pathogens during the hospital stay are directly associated with the occurrence of life-threatening infections. Empiric antimicrobial treatment after the assessment of individual risk factors, local epidemiology of drug-resistant pathogens and possible drug-drug interactions can improve the clinical outcomes.
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Affiliation(s)
- M Dettori
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - N Riccardi
- StopTB Italia Onlus, Milan, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - D Canetti
- StopTB Italia Onlus, Milan, Italy; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - R M Antonello
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, Trieste, Italy
| | - A F Piana
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Palmieri
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - P Castiglia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A A Azara
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M D Masia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G C Ginesu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M L Cossu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M Conti
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - P Pirina
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Fois
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - I Maida
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G Madeddu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - S Babudieri
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - L Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; StopTB Italia Onlus, Milan, Italy.
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3
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Lavatelli F, Natalello A, Marchese L, Ami D, Corazza A, Raimondi S, Mimmi MC, Malinverni S, Mangione PP, Palmer MT, Lampis A, Concardi M, Verona G, Canetti D, Arbustini E, Bellotti V, Giorgetti S. Truncation of the constant domain drives amyloid formation by immunoglobulin light chains. J Biol Chem 2024; 300:107174. [PMID: 38499153 PMCID: PMC11016911 DOI: 10.1016/j.jbc.2024.107174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 03/20/2024] Open
Abstract
AL amyloidosis is a life-threatening disease caused by deposition of immunoglobulin light chains. While the mechanisms underlying light chains amyloidogenesis in vivo remain unclear, several studies have highlighted the role that tissue environment and structural amyloidogenicity of individual light chains have in the disease pathogenesis. AL natural deposits contain both full-length light chains and fragments encompassing the variable domain (VL) as well as different length segments of the constant region (CL), thus highlighting the relevance that proteolysis may have in the fibrillogenesis pathway. Here, we investigate the role of major truncated species of the disease-associated AL55 light chain that were previously identified in natural deposits. Specifically, we study structure, molecular dynamics, thermal stability, and capacity to form fibrils of a fragment containing both the VL and part of the CL (133-AL55), in comparison with the full-length protein and its variable domain alone, under shear stress and physiological conditions. Whereas the full-length light chain forms exclusively amorphous aggregates, both fragments generate fibrils, although, with different kinetics, aggregate structure, and interplay with the unfragmented protein. More specifically, the VL-CL 133-AL55 fragment entirely converts into amyloid fibrils microscopically and spectroscopically similar to their ex vivo counterpart and increases the amorphous aggregation of full-length AL55. Overall, our data support the idea that light chain structure and proteolysis are both relevant for amyloidogenesis in vivo and provide a novel biocompatible model of light chain fibrillogenesis suitable for future mechanistic studies.
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Affiliation(s)
- Francesca Lavatelli
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy; Research Area, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Antonino Natalello
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy.
| | - Loredana Marchese
- Pathology Unit, Fondazione IRCSS Policlinico San Matteo, Pavia, Italy
| | - Diletta Ami
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Alessandra Corazza
- Department of Medicine (DAME), University of Udine, Udine, Italy; Istituto Nazionale Biostrutture e Biosistemi, Roma, Italy
| | - Sara Raimondi
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Maria Chiara Mimmi
- Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvia Malinverni
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - P Patrizia Mangione
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy; Research Area, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Manel Terrones Palmer
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Alessio Lampis
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Monica Concardi
- Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Guglielmo Verona
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy; Centre for Amyloidosis, Division of Medicine, University College London, London, UK
| | - Diana Canetti
- Centre for Amyloidosis, Division of Medicine, University College London, London, UK
| | - Eloisa Arbustini
- Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Vittorio Bellotti
- Research Area, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sofia Giorgetti
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy; Research Area, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
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4
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Verona G, Raimondi S, Canetti D, Mangione PP, Marchese L, Corazza A, Lavatelli F, Gillmore JD, Taylor GW, Bellotti V, Giorgetti S. Degradation versus fibrillogenesis, two alternative pathways modulated by seeds and glycosaminoglycans. Protein Sci 2024; 33:e4931. [PMID: 38380705 PMCID: PMC10880434 DOI: 10.1002/pro.4931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
The mechanism that converts native human transthyretin into amyloid fibrils in vivo is still a debated and controversial issue. Commonly, non-physiological conditions of pH, temperature, or organic solvents are used in in vitro models of fibrillogenesis of globular proteins. Transthyretin amyloid formation can be achieved under physiological conditions through a mechano-enzymatic mechanism involving specific serine proteases such as trypsin or plasmin. Here, we investigate S52P and L111M transthyretin variants, both causing a severe form of systemic amyloidosis mostly targeting the heart at a relatively young age with heterogeneous phenotype among patients. Our studies on thermodynamics show that both proteins are significantly less stable than other amyloidogenic variants. However, despite a similar thermodynamic stability, L111M variant seems to have enhanced susceptibility to cleavage and a lower tendency to form fibrils than S52P in the presence of specific proteases and biomechanical forces. Heparin strongly enhances the fibrillogenic capacity of L111M transthyretin, but has no effect on the S52P variant. Fibrillar seeds similarly affect the fibrillogenesis of both proteins, with a stronger effect on the L111M variant. According to our model of mechano-enzymatic fibrillogenesis, both full-length and truncated monomers, released after the first cleavage, can enter into fibrillogenesis or degradation pathways. Our findings show that the kinetics of the two processes can be affected by several factors, such as intrinsic amyloidogenicity due to the specific mutations, environmental factors including heparin and fibrillar seeds that significantly accelerate the fibrillogenic pathway.
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Affiliation(s)
- Guglielmo Verona
- Centre for AmyloidosisUniversity College LondonLondonUK
- Department of Molecular MedicineUniversity of PaviaPaviaItaly
| | - Sara Raimondi
- Department of Molecular MedicineUniversity of PaviaPaviaItaly
| | - Diana Canetti
- Centre for AmyloidosisUniversity College LondonLondonUK
| | - P. Patrizia Mangione
- Department of Molecular MedicineUniversity of PaviaPaviaItaly
- Research DepartmentFondazione IRCCS Policlinico San MatteoPaviaItaly
| | | | - Alessandra Corazza
- Department of Medicine (DAME)University of UdineUdineItaly
- Istituto Nazionale Biostrutture e BiosistemiRomeItaly
| | - Francesca Lavatelli
- Department of Molecular MedicineUniversity of PaviaPaviaItaly
- Research DepartmentFondazione IRCCS Policlinico San MatteoPaviaItaly
| | | | | | - Vittorio Bellotti
- Research DepartmentFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Sofia Giorgetti
- Department of Molecular MedicineUniversity of PaviaPaviaItaly
- Research DepartmentFondazione IRCCS Policlinico San MatteoPaviaItaly
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Canetti D, Galli L, Lolatto R, Nozza S, Spagnuolo V, Muccini C, Trentacapilli B, Bruzzesi E, Ranzenigo M, Chiurlo M, Castagna A, Gianotti N. Bictegravir/Emtricitabine/Tenofovir Alafenamide Treatment: Efficacy and Tolerability in Clinical Practice. Drug Des Devel Ther 2023; 17:3697-3706. [PMID: 38090027 PMCID: PMC10714985 DOI: 10.2147/dddt.s437043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/11/2023] [Indexed: 12/18/2023] Open
Abstract
Objective Analysis of bictegravir/emtricitabine/tenofovir alafenamide (BFTAF) efficacy and safety in virologically suppressed people living with HIV (PLWH) in clinical practice. Patients and methods The retrospective cohort study, which included adult treatment-experienced and virologically suppressed PLWH, switched to BFTAF from June 2019 to June 2021. Efficacy and safety were evaluated as virological failure (VF=2 consecutive HIV-RNA>50 copies/mL or a single HIV-RNA>400 copies/mL) and treatment failure (TF=VF or discontinuation for any reason) until data freezing (August 2022). Results Of the 1040 PLWH included, 67.8% switched from elvitegravir/cobicistat/FTAF. VF occurred in 4.2% (n=44), with incidence rate of 1.63 per 1000 person-months of follow-up (PMFU) and probability at 24-30 months of 3.8%-4.0%, respectively. Out of the 44 VF, in 75% virological re-suppression was achieved while maintaining BFTAF. Discontinuation occurred in 15% after a median time of 13.5 months of follow-up, with an incidence rate of 5.67 per 1000 PMFU, and a probability at 24-30 months of 11.9%-15.3%, respectively. Main discontinuation reasons were simplification (51.3%) and toxicity (21.8%, involving CNS in half of cases). TF occurred in 18.6% with an incidence rate of 7.01 per 1000 PMFU after a median time of 13.6 observation months; probability at 24-30 months was 14.8%-18.4%, respectively. Conclusion BFTAF has proven effective and well tolerated in clinical practice.
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Affiliation(s)
- Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Laura Galli
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Lolatto
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy
| | - Vincenzo Spagnuolo
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Muccini
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Elena Bruzzesi
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy
| | - Martina Ranzenigo
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy
| | - Matteo Chiurlo
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy
| | - Nicola Gianotti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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Candela C, Galli L, Rizzo A, Mileto D, Canetti D, Gianotti N, Raccagni AR, Bertoni C, Lucente MF, Gismondo MR, Castagna A, Nozza S. Mpox DNA clearance in semen over 6-month follow-up. J Med Virol 2023; 95:e29259. [PMID: 38037499 DOI: 10.1002/jmv.29259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/29/2023] [Accepted: 11/11/2023] [Indexed: 12/02/2023]
Abstract
Sexual intercourse is a well-established way of transmission of mpox infection. However, it is still uncertain whether semen may represent a viral reservoir. The aim of the study was to evaluate the clearance of viral DNA in semen samples from individuals diagnosed with mpox infection over 6-month follow-up. This prospective, observational, single-center study was conducted at IRCCS San Raffaele Scientific Institute, Milan, Italy, between May and October 2022 in 140 individuals who attended Sexual Health Clinic and diagnosed with mpox infection. Semen samples were collected and analyzed by real-time polymerase chain reaction assays. The baseline collection was performed in 64 (46%) of 140 men diagnosed with mpox infection. The viral DNA was detected in 43 (67%) with median cycle threshold (Ct) 34 (interquartile range [IQR] 31-36). The research was repeated in 32 (74%) and viral DNA clearance was observed in all within 6 months in a median time of 10.5 days (IQR 7-33). Viral clearance occurred in all tested individuals, mostly within 2 weeks since the first positive test. These findings suggest a transient presence of viral DNA in semen and do not support the hypothesis of reservoir. More studies on mpox DNA detection in semen with viral culture and extended follow-up are needed.
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Affiliation(s)
| | - Laura Galli
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Gianotti
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Raccagni AR, Diotallevi S, Lolatto R, Lucente MF, Candela C, Gianotti N, Trentacapilli B, Canetti D, Castagna A, Nozza S. Viral blips and virologic failures following mpox vaccination with MVA-BN among people with HIV. AIDS 2023; 37:2365-2369. [PMID: 37773029 DOI: 10.1097/qad.0000000000003733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
OBJECTIVES The study aim was to evaluate whether mpox vaccination with modified vaccinia Ankara-Bavarian Nordic (MVA-BN) may be associated with viral blips or confirmed virologic failures (CVF) in people with HIV (PWH) receiving antiretroviral therapy and the associated factors. DESIGN PWH who received MVA-BN, with HIV-RNA less than 50 copies/ml, and CD4 + lymphocytes at least 200 cells/μl in the 6 months prior to vaccination and at least 1 HIV-RNA determination within 3 months from vaccination. METHODS The primary outcome was occurrence of viral blips (1 HIV-RNA ≥50 copies/ml) and CVF (1 HIV-RNA ≥1000 copies/ml or ≥2 consecutive HIV-RNA ≥50 copies/ml) following MVA-BN. Changes in CD4 + and CD4 + /CD8 + were secondary outcomes. Residual viremia was defined as detectable HIV-RNA less than 50 copies/ml. PWH already vaccinated against smallpox received single-dose MVA-BN. Mann--Whitney rank-sum test or chi-square/Fisher's test applied. RESULTS Overall, 187 PWH were included: 147 received two doses of MVA-BN, 40 single-dose. Six viral blips [incidence rate = 1.59/100-person months of follow-up (PMFU), 95% confidence interval (95% CI) = 0.58-3.47], and three CVFs [incidence rate = 0.80/100-PMFU (95% CI = 0.16-2.33)] were observed. Two CVFs occurred at second dose with presence of detectable HIV-RNA following first one, with high compliance to antiretroviral therapy (ART). PWH with viral blips or CVFs had, prior to first vaccination, more frequently residual viremia [77% ( n = 7) versus 35% ( n = 62), P = 0.01]. No differences in ART ( P = 0.42) and number of MBA-BN doses ( P = 0.40) was found. In two cases of CVFs, ART was changed; all VBs resolved within 1 month. CONCLUSION Although rare, viral blips and CVFs following MVA-BN vaccination among PWH receiving ART were identified. Close monitoring of HIV-RNA during mpox vaccination should be encouraged.
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Affiliation(s)
| | - Sara Diotallevi
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Lolatto
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Nicola Gianotti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Vita-Salute San Raffaele University
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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8
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Mastrangelo A, Monardo R, Galli L, Tomelleri A, Tassan Din C, Canetti D, Messina E, Guffanti M, Danise A, Campochiaro C, Cavalli G, Monti G, Cinque P, Scarpellini P, Landoni G, Ciceri F, Dagna L, Castagna A, Ripa M. High-dose anakinra in addition to standard of care including corticosteroids in patients with severe COVID-19 treated with non-invasive ventilation. Eur J Clin Microbiol Infect Dis 2023; 42:1383-1387. [PMID: 37723323 DOI: 10.1007/s10096-023-04661-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/05/2023] [Indexed: 09/20/2023]
Abstract
Management of COVID-19 patients experiencing persisting respiratory failure despite corticosteroids remains challenging. Data on high-dose intravenous anakinra (HD-ANK) in this context are lacking. We aimed to investigate the impact of HD-ANK on mortality in COVID-19 patients progressing to non-invasive ventilation (NIV) while receiving corticosteroids. We retrospectively analyzed the impact of HD-ANK on 28-day mortality in individuals hospitalized with COVID-19 necessitating NIV after corticosteroid initiation. A total of 256 patients were identified: 146 received standard-of-care only (SOC), and 110 received HD-ANK+SOC. The groups were well-balanced at baseline. In-hospital mortality at 28 days did not differ between the two groups. HD-ANK is not beneficial in patients with severe COVID-19 deteriorating despite corticosteroids.
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Affiliation(s)
- Andrea Mastrangelo
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Roberta Monardo
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Laura Galli
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Alessandro Tomelleri
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Tassan Din
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Diana Canetti
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Emanuela Messina
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Monica Guffanti
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Anna Danise
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Corrado Campochiaro
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulio Cavalli
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Monti
- Vita-Salute San Raffaele University, Milan, Italy
- Anesthesia and Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Cinque
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Paolo Scarpellini
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Giovanni Landoni
- Vita-Salute San Raffaele University, Milan, Italy
- Anesthesia and Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Hematology and Stem Cell Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
| | - Marco Ripa
- Vita-Salute San Raffaele University, Milan, Italy.
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy.
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9
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Raimondi S, Faravelli G, Nocerino P, Mondani V, Baruffaldi A, Marchese L, Mimmi MC, Canetti D, Verona G, Caterino M, Ruoppolo M, Mangione PP, Bellotti V, Lavatelli F, Giorgetti S. Human wild-type and D76N β 2-microglobulin variants are significant proteotoxic and metabolic stressors for transgenic C. elegans. FASEB Bioadv 2023; 5:484-505. [PMID: 37936921 PMCID: PMC10626158 DOI: 10.1096/fba.2023-00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/21/2023] [Accepted: 10/12/2023] [Indexed: 11/09/2023] Open
Abstract
β2-microglobulin (β2-m) is a plasma protein derived from physiological shedding of the class I major histocompatibility complex (MHCI), causing human systemic amyloidosis either due to persistently high concentrations of the wild-type (WT) protein in hemodialyzed patients, or in presence of mutations, such as D76N β2-m, which favor protein deposition in the adulthood, despite normal plasma levels. Here we describe a new transgenic Caenorhabditis elegans (C. elegans) strain expressing human WT β2-m at high concentrations, mimicking the condition that underlies dialysis-related amyloidosis (DRA) and we compare it to a previously established strain expressing the highly amyloidogenic D76N β2-m at lower concentrations. Both strains exhibit behavioral defects, the severity of which correlates with β2-m levels rather than with the presence of mutations, being more pronounced in WT β2-m worms. β2-m expression also has a deep impact on the nematodes' proteomic and metabolic profiles. Most significantly affected processes include protein degradation and stress response, amino acids metabolism, and bioenergetics. Molecular alterations are more pronounced in worms expressing WT β2-m at high concentration compared to D76N β2-m worms. Altogether, these data show that β2-m is a proteotoxic protein in vivo also in its wild-type form, and that concentration plays a key role in modulating pathogenicity. Our transgenic nematodes recapitulate the distinctive features subtending DRA compared to hereditary β2-m amyloidosis (high levels of non-mutated β2-m vs. normal levels of variant β2-m) and provide important clues on the molecular bases of these human diseases.
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Affiliation(s)
- Sara Raimondi
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
| | - Giulia Faravelli
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
| | - Paola Nocerino
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
| | - Valentina Mondani
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
| | - Alma Baruffaldi
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
| | - Loredana Marchese
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
- Research Department Fondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Maria Chiara Mimmi
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
| | - Diana Canetti
- Centre for Amyloidosis, Division of MedicineUniversity College LondonLondonUK
| | - Guglielmo Verona
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
- Centre for Amyloidosis, Division of MedicineUniversity College LondonLondonUK
| | - Marianna Caterino
- Department of Molecular Medicine and Medical BiotechnologyUniversity of Naples "Federico II"NaplesItaly
- CEINGE – Biotecnologie Avanzate s.c.a.r.l.NaplesItaly
| | - Margherita Ruoppolo
- Department of Molecular Medicine and Medical BiotechnologyUniversity of Naples "Federico II"NaplesItaly
- CEINGE – Biotecnologie Avanzate s.c.a.r.l.NaplesItaly
| | - P. Patrizia Mangione
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
- Research Department Fondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Vittorio Bellotti
- Research Department Fondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Francesca Lavatelli
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
- Research Department Fondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Sofia Giorgetti
- Department of Molecular Medicine, Institute of BiochemistryUniversity of PaviaPaviaItaly
- Research Department Fondazione IRCCS Policlinico San MatteoPaviaItaly
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10
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Bruzzesi E, Raccagni AR, Mileto D, Candela C, Canetti D, Castagna A, Nozza S, Tamburini AM. Isolated monkeypox proctitis among men who have sex with men. Infection 2023; 51:1597-1598. [PMID: 37273166 DOI: 10.1007/s15010-023-02051-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/12/2023] [Indexed: 06/06/2023]
Affiliation(s)
| | | | - Davide Mileto
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | | | - Diana Canetti
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Marco Tamburini
- Vita-Salute San Raffaele University, Milan, Italy.
- Gastrointestinal Surgery Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
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11
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Ambrosini F, Riccardi N, Occhineri S, Matucci T, Paraboschi I, Calarco A, Berrettini A, Tiseo G, Canetti D, Van Der Merwe A, Terrone C, Mantica G. Uncommon Haemorrhagic Cystitis of Infectious Origin: A Narrative Review for Urologists. Res Rep Urol 2023; 15:365-373. [PMID: 37564174 PMCID: PMC10411501 DOI: 10.2147/rru.s412278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/20/2023] [Indexed: 08/12/2023] Open
Abstract
Purpose Haemorrhagic cystitis may be due to different etiologies with infectious diseases representing an insidious cause to diagnose. The aim of this narrative review is to provide a comprehensive overview of less common but difficult-to-diagnose causes of infectious haemorrhagic cystitis of bacterial, mycobacterial, and parasitic origin, Moreover, we highlight possible diagnostic tools and currently available treatment options in order to give an updated tool for urologists to use in daily practice. Patients and Methods The search engine PubMed was used to select peer-reviewed articles published from 1/Jan/2010 to 31/Aug/2022. Results Bacteria, fungal, TB and schistosomiasis are uncommon causes of haemorrhagic cystitis burdened by high morbidity, especially if not promptly diagnosed. Conclusion Because haemorrhagic cystitis ranges in severity from mild dysuria associated with pelvic discomfort to severe life-threatening haemorrhage, punctual diagnosis, and immediate treatment are essential to avoid further complications.
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Affiliation(s)
- Francesca Ambrosini
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Niccolò Riccardi
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Sara Occhineri
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Tommaso Matucci
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Irene Paraboschi
- Department of Pediatric Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Alfredo Berrettini
- Department of Pediatric Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giusy Tiseo
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - André Van Der Merwe
- Department of Urology, Faculty of Medicine and Health Sciences, 26697 Stellenbosch University, Cape Town, South Africa
| | - Carlo Terrone
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Guglielmo Mantica
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
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12
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Clemente T, Galli L, Poli A, Borjesson RP, Bresciani L, Muccini C, Canetti D, Candela C, Bossolasco S, Hasson H, Castagna A, Spagnuolo V. Treatment success of rescue regimens after dual therapy failure in people living with HIV in a real-life setting. Int J Antimicrob Agents 2023:106897. [PMID: 37343809 DOI: 10.1016/j.ijantimicag.2023.106897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 06/06/2023] [Accepted: 06/16/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Few data on the management of two-drug regimen (2DR) failure in people living with human immunodeficiency virus (PLWH) are available. METHODS Retrospective study on treatment-experienced PLWH on a 2DR, who underwent virological failure [(VF) two consecutive viral loads (VLs) ≥50 copies/mL, a single VL ≥1000 copies/mL, or an antiretroviral therapy (ART) switch after a single VL ≥50 copies/mL with previous blips] or discontinuation for toxicity (baseline). We included integrase strand transfer inhibitor (INSTI)-based [one INSTI plus one nucleoside reverse transcriptase inhibitor (NRTI) (n=78) or one non-NRTI (n=20)] or boosted protease inhibitor (PI/b)-based [one PI/b plus one NRTI (n=116) or one INSTI (n=12)] 2DRs. Probabilities of treatment success (TS), VF, and discontinuation for any other cause of rescue regimens were estimated by Kaplan-Meier curves. A stepwise Cox model was performed to assess predictors of TS. RESULTS Overall, 226 PLWH were evaluated: at baseline, 144 individuals discontinued 2DR for toxicity and 82 had VF [median viremia 81 (63-212) copies/mL]; 171 switched therapy (49.7% to a triple-regimen, 40.9% to a different 2DR), while 55 (exclusively among those with VF) maintained their failing regimens. The probabilities of 12- and 24-month TS were 75.6% and 64.7%, respectively. Higher TS probabilities were observed in individuals who switched ART at 2DR failure (p=0.003) and in PLWH who discontinued 2DR for toxicity (p=0.008). A therapy switch was the only predictor of TS (p=0.002). CONCLUSIONS Overall probability of success of rescue regimens introduced after 2DR failure is good; an immediate ART switch is associated with higher efficacy, so this approach should be encouraged.
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Affiliation(s)
- Tommaso Clemente
- Vita-Salute San Raffaele University, via Stamira D'Ancona, 20, 20127, Milan, Italy; Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy.
| | - Laura Galli
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Andrea Poli
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Rebecka Papaioannu Borjesson
- Vita-Salute San Raffaele University, via Stamira D'Ancona, 20, 20127, Milan, Italy; Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Livia Bresciani
- Vita-Salute San Raffaele University, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Camilla Muccini
- Vita-Salute San Raffaele University, via Stamira D'Ancona, 20, 20127, Milan, Italy; Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Diana Canetti
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Caterina Candela
- Vita-Salute San Raffaele University, via Stamira D'Ancona, 20, 20127, Milan, Italy; Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Simona Bossolasco
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Hamid Hasson
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, via Stamira D'Ancona, 20, 20127, Milan, Italy; Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Vincenzo Spagnuolo
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
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13
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Fontana M, Gilbertson J, Verona G, Riefolo M, Slamova I, Leone O, Rowczenio D, Botcher N, Ioannou A, Patel RK, Razvi Y, Martinez-Naharro A, Whelan CJ, Venneri L, Duhlin A, Canetti D, Ellmerich S, Moon JC, Kellman P, Al-Shawi R, McCoy L, Simons JP, Hawkins PN, Gillmore JD. Antibody-Associated Reversal of ATTR Amyloidosis-Related Cardiomyopathy. N Engl J Med 2023; 388:2199-2201. [PMID: 37285532 DOI: 10.1056/nejmc2304584] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
| | | | | | - Mattia Riefolo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Ornella Leone
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | | | - Adam Ioannou
- University College London, London, United Kingdom
| | | | - Yousuf Razvi
- University College London, London, United Kingdom
| | | | | | | | | | | | | | - James C Moon
- University College London, London, United Kingdom
| | | | | | - Laura McCoy
- University College London, London, United Kingdom
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14
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Raccagni AR, Ceccarelli D, Trentacapilli B, Galli L, Lolatto R, Canetti D, Bruzzesi E, Candela C, Castagna A, Nozza S. Viral Hepatitis and Human Papillomavirus Vaccination during HIV Pre-exposure Prophylaxis: Factors Associated with Missed Vaccination. J Acquir Immune Defic Syndr 2023; Publish Ahead of Print:00126334-990000000-00239. [PMID: 37220020 DOI: 10.1097/qai.0000000000003216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND We evaluated factors associated with lack of triple vaccination (hepatitis A (HAV), hepatitis B (HBV), human papilloma virus (HPV)] among men who have sex with men (MSM) using pre-exposure prophylaxis (PrEP). SETTING PrEP users at San Raffaele Scientific Institute, Italy, with ≥1 follow-up visit (May 2017-2022). METHODS Participants were considered protected if: i) prior to PrEP access: positive serology (IgG-HAV+, HbsAb>10mUI/ml) or vaccination history were recorded; ii) after starting PrEP: ≥1 dose of each vaccination was administered. Individuals were considered fully protected if they received before/during PrEP access: HAV vaccination/infection, HBV vaccination/infection and HPV vaccination. Chi-square and Kruskal-Wallis tests were used to compare characteristics of those fully, partially and not protected. Factors associated with lack of triple vaccination were assessed by multivariable logistic regression and classification tree analysis. RESULTS Overall, 473 MSM were considered: 146 (31%) were fully protected, 231 (48%) partially and 96 (20%) not. Daily-based PrEP users (fully:93, 63.7%; partially:107, 46.3%; not protected:40, 41.7%; p=0.001) and those with a sexually transmitted infection (STI) at first visit (43, 29.5%; 55, 23.8%; 15, 15.6%; p=0.048) were more frequently fully protected. At multivariable analysis, the odds of lack of triple vaccination was lower among daily-based users (adjusted odds ratio=0.47, 95%CI=0.31-0.70, p<0.001). Classification tree analysis showed that among daily-based users, with an STI prior and at first PrEP visit, there was lower chance of lack of triple vaccination (probability=44%). CONCLUSION Strategies targeting PrEP users at risk of missing HAV, HBV, HPV vaccinations need to be implemented, focusing mostly on event-based users.
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Affiliation(s)
| | - Daniele Ceccarelli
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Laura Galli
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Lolatto
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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15
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Muccini C, Galli L, Sampaolo M, Gianotti N, Castagna A, Canetti D. Increasing trend of transmitted integrase inhibitor resistance in a cohort of antiretroviral therapy-naive people living with HIV. J Antimicrob Chemother 2023; 78:1314-1315. [PMID: 37029656 DOI: 10.1093/jac/dkad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Affiliation(s)
- Camilla Muccini
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, via Stamira D'Ancona 20, Milan 20127, Italy
| | - Laura Galli
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michela Sampaolo
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Institute, Milano, Italy
| | - Nicola Gianotti
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, via Stamira D'Ancona 20, Milan 20127, Italy
| | - Diana Canetti
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Raccagni AR, Canetti D, Mileto D, Tamburini AM, Candela C, Albarello L, Bracchitta F, Mancon A, Micheli V, Gismondo MR, Castagna A, Nozza S. Two individuals with potential monkeypox virus reinfection. Lancet Infect Dis 2023; 23:522-524. [PMID: 37031694 PMCID: PMC10079276 DOI: 10.1016/s1473-3099(23)00185-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 04/11/2023]
Affiliation(s)
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Andrea Marco Tamburini
- Gastrointestinal Surgery Unit, Vita Salute San Raffaele University, Milan, Italy; Gastrointestinal Surgery Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Candela
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy
| | - Luca Albarello
- Department of Pathology, Vita Salute San Raffaele University, Milan, Italy; Department of Pathology, San Raffaele Scientific Institute, Milan, Italy
| | - Fiorenza Bracchitta
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences Luigi Sacco University Hospital, University of Milan, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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Raccagni AR, Poli A, Galli L, Spagnuolo V, Bruzzesi E, Muccini C, Gianotti N, Canetti D, Mainardi I, Castagna A, Nozza S. Association of high-risk sexual behaviours with sexually transmitted infections among men who have sex with men living with HIV. Sex Transm Infect 2023; 99:120-123. [PMID: 35523576 DOI: 10.1136/sextrans-2021-055365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/15/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore different sexual behaviours as risk factors for STI among men who have sex with men (MSM) living with HIV. METHODS This is a cross-sectional study on MSM living with HIV followed at the Infectious Diseases Unit of San Raffaele Hospital, Milan, with at least one diagnosis of gonorrhoea, syphilis, chlamydia or anal human papilloma virus (HPV), between July 2016 and February 2021. We conducted a survey on high-risk sexual behaviours with regard to (1) mean number of partners per month, (2) estimated percentage of condom use and (3) most frequent type of sexual intercourse during 2016-2021. Data on these variables were grouped as follows: (1a) ≤5 vs >5, (1b) >10 vs ≤10, (2a) 0% vs >0%, (2b) ≤50% vs >50%, (2c) 100% vs <100%, (3a) ≥50% vs <50% receptive, (3b) 100% vs <100% insertive, and (3c) 100% vs <100% receptive. A high-risk group was defined as >5 partners, <100% use of condom and ≥50% receptive intercourse. Univariate logistic regressions were applied to assess the association between sexual behaviours and the risk of each STI. RESULTS Out of 1051 MSM with at least one STI diagnosis, 580 (55%) answered the survey. The risk of chlamydia was lower among individuals with ≤5 partners (≤5 partners vs >5 partners: OR=0.43, 95% CI 0.28 to 0.66, p=0.001) and among those using condoms more frequently (≤50% use of condom vs >50% use of condom: OR=1.55, 95% CI 1.06 to 2.27, p=0.025; 100% vs <100%: OR=0.35, 95% CI 0.20 to 0.59, p=0.001). Individuals using condoms more frequently also had lower risk of gonorrhoea (100% use of condom vs <100% use of condom: OR=0.37, 95% CI 0.17 to 0.79, p=0.011). The risks of chlamydia (OR=3.07, 95% CI 1.92 to 4.90, p<0.001) and gonorrhoea (OR=2.05, 95% CI 1.12 to 3.75, p=0.020) were higher among individuals belonging to the high-risk group. CONCLUSIONS Chlamydia and gonorrhoea are more likely associated with high-risk sexual behaviours than syphilis and anal HPV among MSM living with HIV.
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Affiliation(s)
| | - Andrea Poli
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Laura Galli
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | | | - Elena Bruzzesi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Camilla Muccini
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Nicola Gianotti
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Ilaria Mainardi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy.,Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
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18
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Raccagni AR, Bruzzesi E, Spagnuolo V, Canetti D, Castagna A, Nozza S. 'Multidrug-resistant Mycoplasma genitalium urethritis: successful eradication with sequential therapy. Sex Transm Infect 2023; 99:77. [PMID: 36601744 DOI: 10.1136/sextrans-2022-055678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
| | - Elena Bruzzesi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | | | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy.,Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
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19
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Alberton F, Nozza S, Raccagni AR, Galli L, Spagnuolo V, Bossolasco S, Cernuschi M, Canetti D, Hasson H, Castagna A, Gianotti N. The propensity for long-acting cabotegravir and rilpivirine every 2 months among HIV-infected people eligible for treatment. J Med Virol 2023; 95:e28330. [PMID: 36415058 DOI: 10.1002/jmv.28330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Francesca Alberton
- Infectious Disease Unit, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Silvia Nozza
- Infectious Disease Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Angelo Roberto Raccagni
- Infectious Disease Unit, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Galli
- Infectious Disease Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Vincenzo Spagnuolo
- Infectious Disease Unit, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Diana Canetti
- Infectious Disease Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Hamid Hasson
- Infectious Disease Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Antonella Castagna
- Infectious Disease Unit, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicola Gianotti
- Infectious Disease Unit, IRCCS Ospedale San Raffaele, Milan, Italy
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20
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Bertoni C, Raccagni AR, Candela C, Bruzzesi E, Mileto D, Canetti D, Rizzo A, Morsica G, Castagna A, Nozza S. Beyond stigma: Monkeypox infection in a 27-year-old woman. J Med Virol 2023; 95:e28421. [PMID: 36546405 DOI: 10.1002/jmv.28421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/10/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Costanza Bertoni
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Angelo Roberto Raccagni
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Candela
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Elena Bruzzesi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy.,University of Milan, Milan, Italy
| | - Giulia Morsica
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy.,Laboratory of Clinical Microbiology, Virology and Bioemergencies, Sacco Hospital, Milan, Italy
| | - Antonella Castagna
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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21
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Fehmi J, Davies AJ, Antonelou M, Keddie S, Pikkupeura S, Querol L, Delmont E, Cortese A, Franciotta D, Persson S, Barratt J, Pepper R, Farinha F, Rahman A, Canetti D, Gilbertson JA, Rendell NB, Radunovic A, Minton T, Fuller G, Murphy SM, Carr AS, Reilly MR, Eftimov F, Wieske L, Teunissen CE, Roberts ISD, Ashman N, Salama AD, Rinaldi S. Contactin-1 links autoimmune neuropathy and membranous glomerulonephritis. PLoS One 2023; 18:e0281156. [PMID: 36893151 PMCID: PMC9997925 DOI: 10.1371/journal.pone.0281156] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/11/2023] [Indexed: 03/10/2023] Open
Abstract
Membranous glomerulonephritis (MGN) is a common cause of nephrotic syndrome in adults, mediated by glomerular antibody deposition to an increasing number of newly recognised antigens. Previous case reports have suggested an association between patients with anti-contactin-1 (CNTN1)-mediated neuropathies and MGN. In an observational study we investigated the pathobiology and extent of this potential cause of MGN by examining the association of antibodies against CNTN1 with the clinical features of a cohort of 468 patients with suspected immune-mediated neuropathies, 295 with idiopathic MGN, and 256 controls. Neuronal and glomerular binding of patient IgG, serum CNTN1 antibody and protein levels, as well as immune-complex deposition were determined. We identified 15 patients with immune-mediated neuropathy and concurrent nephrotic syndrome (biopsy proven MGN in 12/12), and 4 patients with isolated MGN from an idiopathic MGN cohort, all seropositive for IgG4 CNTN1 antibodies. CNTN1-containing immune complexes were found in the renal glomeruli of patients with CNTN1 antibodies, but not in control kidneys. CNTN1 peptides were identified in glomeruli by mass spectroscopy. CNTN1 seropositive patients were largely resistant to first-line neuropathy treatments but achieved a good outcome with escalation therapies. Neurological and renal function improved in parallel with suppressed antibody titres. The reason for isolated MGN without clinical neuropathy is unclear. We show that CNTN1, found in peripheral nerves and kidney glomeruli, is a common target for autoantibody-mediated pathology and may account for between 1 and 2% of idiopathic MGN cases. Greater awareness of this cross-system syndrome should facilitate earlier diagnosis and more timely use of effective treatment.
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Affiliation(s)
- Janev Fehmi
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Alexander J Davies
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Marilina Antonelou
- University College London Department of Renal Medicine, Royal Free Hospital, London, United Kingdom
| | - Stephen Keddie
- Centre for Neuromuscular Disease, National Hospital of Neurology and Neurosurgery and Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Sonja Pikkupeura
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Luis Querol
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Emilien Delmont
- Referral Centre for ALS and Neuromuscular Diseases, Hospital La Timone, Marseille, France
| | - Andrea Cortese
- Centre for Neuromuscular Disease, National Hospital of Neurology and Neurosurgery and Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, United Kingdom.,Department of Brain and Behaviour sciences, University of Pavia, Pavia, Italy
| | | | - Staffan Persson
- Faculty of Medicine, Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden
| | - Jonathan Barratt
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Ruth Pepper
- University College London Department of Renal Medicine, Royal Free Hospital, London, United Kingdom
| | - Filipa Farinha
- Centre for Rheumatology and Bloomsbury Rheumatology Unit, Division of Medicine, University College London, London, United Kingdom
| | - Anisur Rahman
- Centre for Rheumatology and Bloomsbury Rheumatology Unit, Division of Medicine, University College London, London, United Kingdom
| | - Diana Canetti
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
| | - Janet A Gilbertson
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
| | - Nigel B Rendell
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
| | - Aleksandar Radunovic
- Barts Neuromuscular Diseases Centre, Royal London Hospital, London, United Kingdom
| | - Thomas Minton
- Institute of Clinical Neurosciences, University of Bristol, Bristol, United Kingdom
| | - Geraint Fuller
- Department of Neurology, Gloucestershire Royal Hospital, Gloucester, United Kingdom
| | - Sinead M Murphy
- Department of Neurology, Tallaght University Hospital & Academic Unit of Neurology, Trinity College, Dublin, Ireland
| | - Aisling S Carr
- Centre for Neuromuscular Disease, National Hospital of Neurology and Neurosurgery and Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Mary R Reilly
- Centre for Neuromuscular Disease, National Hospital of Neurology and Neurosurgery and Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Filip Eftimov
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Luuk Wieske
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Ian S D Roberts
- Department of Cellular Pathology, John Radcliffe Hospital, Oxford, United Kingdom
| | - Neil Ashman
- Barts Renal Unit, The Royal London Hospital, London, United Kingdom
| | - Alan D Salama
- University College London Department of Renal Medicine, Royal Free Hospital, London, United Kingdom
| | - Simon Rinaldi
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
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22
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Raccagni AR, Candela C, Bruzzesi E, Mileto D, Canetti D, Rizzo A, Castagna A, Nozza S. Real-life use of cidofovir for the treatment of severe monkeypox cases. J Med Virol 2023; 95:e28218. [PMID: 36229902 DOI: 10.1002/jmv.28218] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 01/11/2023]
Affiliation(s)
| | - Caterina Candela
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Bruzzesi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy.,Laboratory of Clinical Microbiology, Virology and Bioemergencies, University of Milan, Milan, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy.,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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23
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Antonello RM, Canetti D, Riccardi N. Daptomycin synergistic properties from in vitro and in vivo studies: a systematic review. J Antimicrob Chemother 2022; 78:52-77. [PMID: 36227704 DOI: 10.1093/jac/dkac346] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/21/2022] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Daptomycin is a bactericidal lipopeptide antibiotic approved for the treatment of systemic infections (i.e. skin and soft tissue infections, bloodstream infections, infective endocarditis) caused by Gram-positive cocci. It is often prescribed in association with a partner drug to increase its bactericidal effect and to prevent the emergence of resistant strains during treatment; however, its synergistic properties are still under evaluation. METHODS We performed a systematic review to offer clinicians an updated overview of daptomycin synergistic properties from in vitro and in vivo studies. Moreover, we reported all in vitro and in vivo data evaluating daptomycin in combination with other antibiotic agents, subdivided by antibiotic classes, and a summary graph presenting the most favourable combinations at a glance. RESULTS A total of 92 studies and 1087 isolates (723 Staphylococcus aureus, 68 Staphylococcus epidermidis, 179 Enterococcus faecium, 105 Enterococcus faecalis, 12 Enterococcus durans) were included. Synergism accounted for 30.9% of total interactions, while indifferent effect was the most frequently observed interaction (41.9%). Antagonistic effect accounted for 0.7% of total interactions. The highest synergistic rates against S. aureus were observed with daptomycin in combination with fosfomycin (55.6%). For S. epidermidis and Enterococcus spp., the most effective combinations were daptomycin plus ceftobiprole (50%) and daptomycin plus fosfomycin (63.6%) or rifampicin (62.8%), respectively. FUTURE PERSPECTIVES We believe this systematic review could be useful for the future updates of guidelines on systemic infections where daptomycin plays a key role.
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Affiliation(s)
- Roberta Maria Antonello
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50121, Italy
| | - Diana Canetti
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy
| | - Niccolò Riccardi
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa 56124, Italy
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24
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Nozza S, Raccagni AR, Lolatto R, Ceccarelli D, Galli L, Alberton F, Bruzzesi E, Canetti D, Strano M, Ripa M, Bertoni C, Castagna A. Characteristics of HIV pre-exposure prophylaxis users at first PrEP counselling visit: the CSL-PrEP cohort. BMJ Open 2022; 12:e067261. [PMID: 36600429 PMCID: PMC9772673 DOI: 10.1136/bmjopen-2022-067261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Pre-exposure prophylaxis (PrEP) is effective for HIV prevention and is mostly used by men who have sex with men (MSM). The aim of this study was to describe the characteristics of a cohort of PrEP users at first PrEP counselling visits (baseline, BL). DESIGN Cross-sectional study of a cohort of MSM receiving PrEP (Centro San Luigi, CSL-PrEP Cohort). SETTING Secondary-level sexually transmitted infections (STI) centre in Milan, Italy, from May 2017 to May 2022. PARTICIPANTS Overall, 624 MSM PrEP users were included; most users were Caucasian (97%), attended university (64%), with a median BL age of 34.5 years. RESULTS Overall, 45% choose the daily-based PrEP regimen, 55% the event-based one. An increasing trend in PrEP counselling visits was observed (p=0.024). The majority had between 10 and 19 partners in the 3 months before BL and 41% were chemsex users. All had a HIV Incidence Risk Index for MSM (HIRI-MSM)>10, 54% between 20 and 29. Overall, 50% had ≥1 previous STI and 22% ≥1 BL STI. BL chlamydia (10%) was often more frequent than in the past (7%). The number of sexual partners was associated with BL chlamydia (p<0.001), gonorrhoea (p=0.002) and syphilis (p=<0.001), HIRI-MSM with chlamydia (p=0.001) and gonorrhoea (p=0.008), chemsex use with chlamydia (p=0.003) and gonorrhoea (p=0.030). CONCLUSIONS We observed an unbalanced access to PrEP in respect to all key populations which might benefit from PrEP, with a similar choice for event-based or daily-based regimens. High-risk behaviours and STIs were frequently observed. History of chlamydia was very frequently high in asymptomatic MSM at BL, compared with what observed before access to PrEP. High-risk behaviours and HIRI-MSM were associated with most of STIs.
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Affiliation(s)
- Silvia Nozza
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | | | | | | | - Laura Galli
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Francesca Alberton
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Elena Bruzzesi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Martina Strano
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Marco Ripa
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Costanza Bertoni
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
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25
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Raccagni AR, Candela C, Mileto D, Bruzzesi E, Canetti D, Bertoni C, Castagna A, Nozza S. Breakthrough monkeypox infection among individuals previously immunized with smallpox or monkeypox vaccination. J Infect 2022; 86:154-225. [PMID: 36481365 PMCID: PMC9721380 DOI: 10.1016/j.jinf.2022.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | | | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy,Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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26
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Riccardi N, Antonello RM, Giacomelli A, Saderi L, Canetti D, Pallotto C, Mazzaferri F, Degli Antoni AM, Cardellino C, Motta I, Calcagno A, Falcone M, Trezzi M, Comelli A, Pascale R, Merli M, Binda F, Angheben A, Sotgiu G, Gobbi F, Nozza S. The challenge of infectious diseases consultations in the emergency department: an Italian nationwide survey. New Microbiol 2022; 45:260-268. [PMID: 36190370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 06/16/2023]
Abstract
Diagnosis and management of infectious diseases (ID) at the emergency department (ED) are challenging due to the peculiar setting and the available diagnostic tools. The involvement of an ID consultant has been described to improve clinical outcomes and antimicrobial stewardship (AMS) programs. An online survey was sent to 100 Italian Departments of Infectious Diseases affiliated with the Italian Society of Infectious Diseases and Tropical Medicine (SIMIT). The primary objective of our study was to describe the characteristics of ID services in Italian EDs to identify possible challenges and shortcomings and provide tips to improve the management of patients. Secondary objectives included the evaluation of diagnostic capability and the management of patients with suspected or confirmed ID. Seventy-six out of the 100 SIMIT centers, 32 (42.1%) of which were teaching hospitals, answered the survey. In 62 (82.7%) centers, consultations were performed by the IDs specialist on call. In 29 (38.2%) centers, there was a formal AMS program, and 32 (42.7%) had protocols for antibiotic use in the ED. Microbiological tests to be performed before starting antibiotic treatment in the ED were clearly defined in 44 (57.9%) hospitals. This survey highlighted several challenges in the current organization of ID consultations in Italian EDs.
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Affiliation(s)
- Niccolò Riccardi
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
- StopTB Italia Onlus, Milan, Italy
| | | | - Andrea Giacomelli
- StopTB Italia Onlus, Milan, Italy
- Department of Biomedical and Clinical Sciences DIBIC L. Sacco, University of Milan, 20157 Milan, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Diana Canetti
- StopTB Italia Onlus, Milan, Italy
- Department of Infectious and Tropical Diseases San Raffaele Hospital, 20132 Milan, Italy
| | - Carlo Pallotto
- Infectious Diseases Unit, Santa Maria Annunziata Hospital, Azienda USL Toscana Centro, 50012 Bagno a Ripoli, Florence, Italy
| | - Fulvia Mazzaferri
- Infectious Diseases Section, Department of Diagnostic and Public Health, University of Verona, 37129 Verona, Italy
| | - Anna Maria Degli Antoni
- Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, 34126 Parma, Italy
| | - Chiara Cardellino
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Valpolicella di Negrar, Verona, Italy
| | - Ilaria Motta
- University of Turin, AO "Amedeo di Savoia", Department of Medical Sciences, Infectious Diseases, 10149 Turin, Italy
| | - Andrea Calcagno
- University of Turin, AO "Amedeo di Savoia", Department of Medical Sciences, Infectious Diseases, 10149 Turin, Italy
| | - Marco Falcone
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Michele Trezzi
- Division of Infectious Diseases, Azienda USL Toscana Centro, Hospital of Pistoia, 51100 Pistoia, Italy
| | - Agnese Comelli
- Department of Infectious & Tropical Diseases, Spedali Civili, 25123 Brescia, Italy
| | - Renato Pascale
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy
| | - Marco Merli
- Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Francesca Binda
- Division of Infectious Diseases, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Andrea Angheben
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Valpolicella di Negrar, Verona, Italy
| | - Giovanni Sotgiu
- StopTB Italia Onlus, Milan, Italy
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Federico Gobbi
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Valpolicella di Negrar, Verona, Italy
| | - Silvia Nozza
- Department of Infectious and Tropical Diseases San Raffaele Hospital, 20132 Milan, Italy
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27
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Canetti D, Riccardi N, Antonello RM, Nozza S, Sotgiu G. Mycobacterium marinum: A brief update for clinical purposes. Eur J Intern Med 2022; 105:15-19. [PMID: 35864075 DOI: 10.1016/j.ejim.2022.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
Mycobacterium marinum (M. marinum) is a free-living, slow grower nontuberculous mycobacteria (NTM), strictly related to Mycobacterium tuberculosis, that causes disease in fresh and saltwater fish and it is one of the causes of extra-pulmonary mycobacterial infections, ranging in human from simple cutaneous lesions to disseminated forms in immunocompromised hosts. The first human cases of M. marinum infection were reported from skin lesions of swimmers in a contaminated pool, in 1951, in Sweden by Norden and Linell. Two conditions are required to develop M. marinum infection: (1) skin solution of continuity and (2) exposure to the contaminated water or direct contact with fish or shellfish. The so-called "fish-tank granuloma", the most frequent cutaneous manifestation of M. marinum infection, is characterized by a single papulonodular, verrucose and/or ulcerated granulomatous lesion in the inoculum site. Careful patient's history collection, high clinical suspicion and appropriate sample (e.g. cutaneous biopsy) for microbiological culture are crucial for a timely diagnosis. The treatment is not standardized yet and relies on administration of two active antimycobacterial agents, always guided by antimicrobial susceptibility test on culture, with macrolides and rifampin as pivotal drugs, as well as prompt surgery when feasible. In this narrative review, we provide to Clinicians an updated report of epidemiology, microbiological characteristics, clinical presentation, diagnosis, and management of M. marinum infection.
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Affiliation(s)
- Diana Canetti
- StopTB Italia Onlus, Milan, Italy; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Niccolò Riccardi
- StopTB Italia Onlus, Milan, Italy; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy.
| | | | - Silvia Nozza
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Giovanni Sotgiu
- StopTB Italia Onlus, Milan, Italy; Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
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28
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Clemente T, Canetti D, Dagna L, Uberti Foppa C, Castagna A, Spagnuolo V, Nozza S, Campochiaro C. Monkeypox in a patient with undifferentiated connective tissue disease. Rheumatology (Oxford) 2022; 62:e158-e160. [PMID: 36193997 PMCID: PMC10152274 DOI: 10.1093/rheumatology/keac568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/14/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tommaso Clemente
- Vita-Salute San Raffaele University, Milan, Italy-Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy, Address: via Stamira D'Ancona, 20, Milan, 20127, Italy
| | - Diana Canetti
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy, Address: via Stamira D'Ancona, 20, Milan, 20127, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy-Vita-Salute San Raffaele University, Milan, Italy, Address: via Olgettina, 60, Milan, 20132, Italy
| | - Caterina Uberti Foppa
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy-Vita-Salute San Raffaele University, Milan, Italy, Address: via Stamira D'Ancona, 20, Milan, 20127, Italy
| | - Antonella Castagna
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy-Vita-Salute San Raffaele University, Milan, Italy, Address: via Stamira D'Ancona, 20, Milan, 20127, Italy
| | - Vincenzo Spagnuolo
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy, Address: via Stamira D'Ancona, 20, Milan, 20127, Italy
| | - Silvia Nozza
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy, Address: via Stamira D'Ancona, 20, Milan, 20127, Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy-Vita-Salute San Raffaele University, Milan, Italy, Address: via Olgettina, 60, Milan, 20132, Italy
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Raccagni AR, Mileto D, Canetti D, Tamburini AM, Rizzo A, Bruzzesi E, Castagna A, Nozza S. Monkeypox and pan-resistant Campylobacter spp infection in Entamoeba histolytica and Chlamydia trachomatis re-infection in a man who have sex with men. J Infect 2022; 85:436-480. [PMID: 35788011 DOI: 10.1016/j.jinf.2022.06.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022]
Affiliation(s)
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Marco Tamburini
- Vita-Salute San Raffele University, Via Stamira D'Ancona 20, Milan 20127, Italy; Gastrointestinal Surgery Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy; University of Milan, Milan, Italy
| | - Elena Bruzzesi
- Vita-Salute San Raffele University, Via Stamira D'Ancona 20, Milan 20127, Italy
| | - Antonella Castagna
- Vita-Salute San Raffele University, Via Stamira D'Ancona 20, Milan 20127, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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30
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Canetti D, Antonello RM, Saderi L, Giro M, Goletti D, Sarmati L, Rodari P, Bocchino M, Schirò M, Riccardi N, Sotgiu G. Impact of SARS-CoV-2 infection on tuberculosis outcome and follow-up in Italy during the first COVID-19 pandemic wave: a nationwide online survey. Infez Med 2022; 30:418-426. [PMID: 36148161 PMCID: PMC9448321 DOI: 10.53854/liim-3003-10] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND SARS-CoV-2 pandemic affected tuberculosis (TB) management. This Italian nationwide survey assessed COVID-19 impact on TB care and outcomes. MATERIALS AND METHODS Twenty-one hospitals or referral centres fulfilled an online survey. Primary objective was to describe clinical features, outcomes and retention in care in subjects with latent TB infection (LTBI) or disease over the first wave of COVID-19 pandemic. Secondary objectives were the assessment of risk factors, co-morbidities, diagnostics, radiological findings, and outcomes of COVID-19 in the study population. RESULTS 254 patients with LTBI or active TB were included. In co-infected (SARS-CoV-2, LTBI/TB) patients, recovery occurred in 29/32 (90.6%) cases, death in one case. High retention in care was preserved. CONCLUSION in our cohort, outcomes did not seem to be adversely conditioned by incident COVID-19.
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Affiliation(s)
- Diana Canetti
- StopTB Italia Onlus, Milan, Italy
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | | | - Delia Goletti
- StopTB Italia Onlus, Milan, Italy
- National Institute for Infectious Diseases (INMI) “L. Spallanzani” - IRCCS, Rome, Italy
| | | | - Paola Rodari
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Marialuisa Bocchino
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, Naples, Italy
| | - Miriam Schirò
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, Naples, Italy
| | - Niccolò Riccardi
- StopTB Italia Onlus, Milan, Italy
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - Giovanni Sotgiu
- StopTB Italia Onlus, Milan, Italy
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
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31
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Raccagni AR, Candela C, Mileto D, Canetti D, Bruzzesi E, Rizzo A, Castagna A, Nozza S. Monkeypox infection among men who have sex with men: PCR testing on seminal fluids. J Infect 2022; 85:573-607. [PMID: 35914609 PMCID: PMC9556608 DOI: 10.1016/j.jinf.2022.07.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022]
Affiliation(s)
| | - Caterina Candela
- Vita-Salute San Raffaele University, Via Stamira D'Ancona 20, Milano, Milan 20127, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Elena Bruzzesi
- Vita-Salute San Raffaele University, Via Stamira D'Ancona 20, Milano, Milan 20127, Italy
| | - Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, Ospedale Sacco, Milan, Italy; University of Milan, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Via Stamira D'Ancona 20, Milano, Milan 20127, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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32
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Bruzzesi E, Raccagni AR, Canetti D, Galli L, Badalucco F, Mori G, Chiurlo M, Guffanti M, Castagna A, Nozza S. PROCTITIS AND PROSTATITIS BY NEISSERIA MENINGITIDIS AMONG MSM: A CASE SERIES. J Infect 2022; 85:174-211. [PMID: 35483454 DOI: 10.1016/j.jinf.2022.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Laura Galli
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | - Monica Guffanti
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy; Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
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33
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Faravelli G, Mondani V, Mangione PP, Raimondi S, Marchese L, Lavatelli F, Stoppini M, Corazza A, Canetti D, Verona G, Obici L, Taylor GW, Gillmore JD, Giorgetti S, Bellotti V. Amyloid Formation by Globular Proteins: The Need to Narrow the Gap Between in Vitro and in Vivo Mechanisms. Front Mol Biosci 2022; 9:830006. [PMID: 35237660 PMCID: PMC8883118 DOI: 10.3389/fmolb.2022.830006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/20/2022] [Indexed: 11/15/2022] Open
Abstract
The globular to fibrillar transition of proteins represents a key pathogenic event in the development of amyloid diseases. Although systemic amyloidoses share the common characteristic of amyloid deposition in the extracellular matrix, they are clinically heterogeneous as the affected organs may vary. The observation that precursors of amyloid fibrils derived from circulating globular plasma proteins led to huge efforts in trying to elucidate the structural events determining the protein metamorphosis from their globular to fibrillar state. Whereas the process of metamorphosis has inspired poets and writers from Ovid to Kafka, protein metamorphism is a more recent concept. It is an ideal metaphor in biochemistry for studying the protein folding paradigm and investigating determinants of folding dynamics. Although we have learned how to transform both normal and pathogenic globular proteins into fibrillar polymers in vitro, the events occurring in vivo, are far more complex and yet to be explained. A major gap still exists between in vivo and in vitro models of fibrillogenesis as the biological complexity of the disease in living organisms cannot be reproduced at the same extent in the test tube. Reviewing the major scientific attempts to monitor the amyloidogenic metamorphosis of globular proteins in systems of increasing complexity, from cell culture to human tissues, may help to bridge the gap between the experimental models and the actual pathological events in patients.
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Affiliation(s)
- Giulia Faravelli
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Valentina Mondani
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - P. Patrizia Mangione
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Wolfson Drug Discovery Unit, Division of Medicine, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, United Kingdom
| | - Sara Raimondi
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Loredana Marchese
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Francesca Lavatelli
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Monica Stoppini
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Alessandra Corazza
- Department of Medicine (DAME), University of Udine, Udine, Italy
- Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
| | - Diana Canetti
- Wolfson Drug Discovery Unit, Division of Medicine, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, United Kingdom
| | - Guglielmo Verona
- Wolfson Drug Discovery Unit, Division of Medicine, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, United Kingdom
| | - Laura Obici
- Amyloidosis Research and Treatment Centre, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Graham W. Taylor
- Wolfson Drug Discovery Unit, Division of Medicine, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, United Kingdom
| | - Julian D. Gillmore
- National Amyloidosis Centre, University College London and Royal Free Hospital, London, United Kingdom
| | - Sofia Giorgetti
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
| | - Vittorio Bellotti
- Unit of Biochemistry, Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Wolfson Drug Discovery Unit, Division of Medicine, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, United Kingdom
- Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
- Scientific Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- *Correspondence: Vittorio Bellotti, ,
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34
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Raccagni AR, Bruzzesi E, Gianotti N, Sampaolo M, Canetti D, Castagna A, Nozza S. Failure of on-demand pre-exposure prophylaxis: the risk of HIV drug resistance. Sex Transm Infect 2022; 98:234. [PMID: 35039436 DOI: 10.1136/sextrans-2021-055354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Elena Bruzzesi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Nicola Gianotti
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | | | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy.,Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
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35
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Muccini C, Canetti D, Castagna A, Spagnuolo V. Efficacy and Safety Profile of Fostemsavir for the Treatment of People with Human Immunodeficiency Virus-1 (HIV-1): Current Evidence and Place in Therapy. Drug Des Devel Ther 2022; 16:297-304. [PMID: 35115764 PMCID: PMC8800563 DOI: 10.2147/dddt.s273660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/14/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Camilla Muccini
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Diana Canetti
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Antonella Castagna
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Vincenzo Spagnuolo
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Hospital, Milan, Italy
- Correspondence: Vincenzo Spagnuolo, Unit of Infectious Diseases, IRCCS Ospedale San Raffaele, Via Stamira d’Ancona 20, Milan, Italy, Tel +390226437907, Fax +390226437903, Email
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36
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Riccardi N, Canetti D, Rodari P, Besozzi G, Saderi L, Dettori M, Codecasa LR, Sotgiu G. Tuberculosis and pharmacological interactions: A narrative review. Curr Res Pharmacol Drug Discov 2021; 2:100007. [PMID: 34909643 PMCID: PMC8663953 DOI: 10.1016/j.crphar.2020.100007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 02/04/2023] Open
Abstract
Even if major improvements in therapeutic regimens and treatment outcomes have been progressively achieved, tuberculosis (TB) remains the leading cause of death from a single infectious microorganism. To improve TB treatment success as well as patients' quality of life, drug-drug-interactions (DDIs) need to be wisely managed. Comprehensive knowledge of anti-TB drugs, pharmacokinetics and pharmacodynamic (PK/PD) parameters, potential patients’ changes in absorption and distribution, possible side effects and interactions, is mandatory to built effective anti-TB regimens. Optimization of treatments and adherence to international guidelines can help bend the curve of TB-related mortality and, ultimately, decrease the likelihood of treatment failure and drop-out during anti-TB treatment. Aim of this paper is to describe the most relevant DDIs between anti-TB and other drugs used in daily clinical practice, providing an updated and “easy-to-use” guide to minimize adverse effects, drop-outs and, in the long run, increase treatment success. Tuberculosis (TB) remains the leading cause of death from a single infectious microorganism. Comprehensive knowledge of anti-TB drugs and PK/PD parameters is mandatory to built effective anti-TB regimens. Drug-drug-interactions (DDIs) need to be avoided and/or wisely managed to ensure treatment success. Optimization of anti-TB treatment to avoid DDIs can help to bend the curve of TB related mortality.
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Affiliation(s)
- Niccolò Riccardi
- StopTB Italia Onlus, Milan, Italy
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Diana Canetti
- StopTB Italia Onlus, Milan, Italy
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Rodari
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | | | - Laura Saderi
- StopTB Italia Onlus, Milan, Italy
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Marco Dettori
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Luigi R. Codecasa
- StopTB Italia Onlus, Milan, Italy
- Regional TB Reference Centre, Villa Marelli Inst., Niguarda Hospital, Milan, Italy
| | - Giovanni Sotgiu
- StopTB Italia Onlus, Milan, Italy
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
- Corresponding author. Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
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37
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Canetti D, Nocerino P, Rendell NB, Botcher N, Gilbertson JA, Blanco A, Rowczenio D, Morelli A, Mangione PP, Corazza A, Verona G, Giorgetti S, Marchese L, Westermark P, Hawkins PN, Gillmore JD, Bellotti V, Taylor GW. Clinical ApoA-IV amyloid is associated with fibrillogenic signal sequence. J Pathol 2021; 255:311-318. [PMID: 34331462 PMCID: PMC9291309 DOI: 10.1002/path.5770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/01/2021] [Accepted: 07/27/2021] [Indexed: 11/11/2022]
Abstract
Apolipoprotein A‐IV amyloidosis is an uncommon form of the disease normally resulting in renal and cardiac dysfunction. ApoA‐IV amyloidosis was identified in 16 patients attending the National Amyloidosis Centre and in eight clinical samples received for histology review. Unexpectedly, proteomics identified the presence of ApoA‐IV signal sequence residues (p.18‐43 to p.20‐43) in 16/24 trypsin‐digested amyloid deposits but in only 1/266 non‐ApoA‐IV amyloid samples examined. These additional signal residues were also detected in the cardiac sample from the Swedish patient in which ApoA‐IV amyloid was first described, and in plasma from a single cardiac ApoA‐IV amyloidosis patient. The most common signal‐containing peptide observed in ApoA‐IV amyloid, p.20‐43, and to a far lesser extent the N‐terminal peptide, p.21‐43, were fibrillogenic in vitro at physiological pH, generating Congo red‐positive fibrils. The addition of a single signal‐derived alanine residue to the N‐terminus has resulted in markedly increased fibrillogenesis. If this effect translates to the mature circulating protein in vivo, then the presence of signal may result in preferential deposition as amyloid, perhaps acting as seed for the main circulating native form of the protein; it may also influence other ApoA‐IV‐associated pathologies. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Diana Canetti
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Paola Nocerino
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Nigel B Rendell
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Nicola Botcher
- National Amyloidosis Centre, University College London and Royal Free Hospital, London, UK
| | - Janet A Gilbertson
- National Amyloidosis Centre, University College London and Royal Free Hospital, London, UK
| | - Angel Blanco
- National Amyloidosis Centre, University College London and Royal Free Hospital, London, UK
| | - Dorota Rowczenio
- National Amyloidosis Centre, University College London and Royal Free Hospital, London, UK
| | - Alessandra Morelli
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - P Patrizia Mangione
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK.,Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | | | - Guglielmo Verona
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Sofia Giorgetti
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Loredana Marchese
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Per Westermark
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Philip N Hawkins
- National Amyloidosis Centre, University College London and Royal Free Hospital, London, UK
| | - Julian D Gillmore
- National Amyloidosis Centre, University College London and Royal Free Hospital, London, UK
| | - Vittorio Bellotti
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK.,Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Graham W Taylor
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
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38
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Berruti M, Riccardi N, Canetti D, Lo Caputo S, Taramasso L, Di Biagio A. Injectable Antiretroviral Drugs: Back to the Future. Viruses 2021; 13:v13020228. [PMID: 33540877 PMCID: PMC7913057 DOI: 10.3390/v13020228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/27/2022] Open
Abstract
Current HIV treatment regimens provide sustained virologic suppression, at least partially restore the immune system and have limited side effects; however, they do not allow viral eradication and they are burdened by daily pill intake with a life-long commitment for the people living with HIV (PHIV). Injectable agents might represent a turning point in the care of PHIV, allowing less frequent administration of antiretroviral treatment (ART), more widespread use of pre-exposure prophylaxis (PrEP) and more stable drug levels in the blood, thus increasing the odds to get closer to end the HIV pandemic. The aim of this manuscript is to give a comprehensive review of injectable antiretrovirals that have been used in the past, which are available now, will be available in the future, and their role in the treatment of HIV infection
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Affiliation(s)
- Marco Berruti
- Infectious Diseases Unit, Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Niccolò Riccardi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy;
| | - Diana Canetti
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20097 Milan, Italy;
- School of Medicine, Vita-Salute San Raffaele University, 20097 Milan, Italy
| | - Sergio Lo Caputo
- Clinic of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Lucia Taramasso
- Infectious Diseases Unit, Department of Internal Medicine, Ospedale Policlinico San Martino IRCCS, 16132 Genoa, Italy;
| | - Antonio Di Biagio
- Infectious Diseases Unit, Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
- Infectious Diseases Unit, Department of Internal Medicine, Ospedale Policlinico San Martino IRCCS, 16132 Genoa, Italy;
- Correspondence:
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39
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Riccardi N, Villa S, Canetti D, Giacomelli A, Taramasso L, Martini M, Di Biagio A, Bragazzi NL, Brigo F, Sotgiu G, Besozzi G, Codecasa L. Missed opportunities in tb clinical practice: How to bend the curve? A medical, social, economic and ethical point of view. Tuberculosis (Edinb) 2020; 126:102041. [PMID: 33385833 DOI: 10.1016/j.tube.2020.102041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/10/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Niccolò Riccardi
- StopTB Italia Onlus, Milan, Italy; Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Simone Villa
- StopTB Italia Onlus, Milan, Italy; Centre for Multidisciplinary Research in Health Science, University of Milan, Milan, Italy
| | - Diana Canetti
- StopTB Italia Onlus, Milan, Italy; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Giacomelli
- StopTB Italia Onlus, Milan, Italy; Department of Biomedical and Clinical Sciences DIBIC L. Sacco, University of Milan, Milan, Italy
| | - Lucia Taramasso
- Infectious Diseases Clinic, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | | | - Antonio Di Biagio
- StopTB Italia Onlus, Milan, Italy; Infectious Diseases Clinic, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | | | - Francesco Brigo
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy
| | - Giovanni Sotgiu
- StopTB Italia Onlus, Milan, Italy; Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | - Luigi Codecasa
- StopTB Italia Onlus, Milan, Italy; Regional TB Reference Centre, Istituto Villa Marelli, Niguarda Hospital, Milan, Italy
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40
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Abstract
Introduction: Oral pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) represent the cornerstones of HIV infection prevention and treatment. However, despite their high efficacy, the need to take daily oral pill(s) negatively impacts long-term patient adherence. In some cases, it can also be associated with drug-drug interactions and adverse gastrointestinal effects, as well as being a constant reminder to individuals of their HIV status. The availability of long-acting non-orally administered antiretroviral drugs could, therefore, be extremely useful. Cabotegravir (CAB) is a second-generation integrase strand transfer inhibitor, characterized by a relatively high genetic barrier and good antiretroviral potency, which is administrable as a long-acting injectable suspension (LAI CAB).Areas covered: The authors present and discuss the efficacy and available safety data of LAI CAB, either when co-administered with rilpivirine (RPV; LAI CAB + RPV) for the treatment of HIV infection, or when used as single agent for PrEP.Expert opinion: Cabotegravir has the potential to play a primary role in the treatment and prevention of HIV infection. The future availability of LAI CAB + RPV and LAI CAB may mark the beginning of an era of LAI ART and PrEP, respectively.
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Affiliation(s)
- Diana Canetti
- Division of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Vincenzo Spagnuolo
- Division of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
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41
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Canetti D, Dell'Acqua R, Riccardi N, Della Torre L, Bigoloni A, Muccini C, Bruzzesi E, Ranzenigo M, Chiurlo M, Racca S, Galli C, Castagna A, Tambussi G, Lazzarin A. SARS-CoV-2 IgG/IgM Rapid Test as a Diagnostic Tool in Hospitalized Patients and Healthcare Workers, at a large Teaching Hospital in northern Italy, during the 2020 COVID-19 Pandemic. New Microbiol 2020; 43:161-165. [PMID: 33135083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 06/11/2023]
Abstract
We describe the outcome of a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) IgG/IgM rapid test, and discuss the potential suitability of antibody testing. Retrospective single cohort study on patients with suspected Coronavirus Disease 2019 (COVID-19) and asymptomatic Healthcare Workers, enrolled from March to April 2020. Subjects had quantitative PCR (qPCR) test for detection of SARS-CoV-2 via nasal swab and serological testing using the COVID-19 IgG/ IgM Rapid Test (PRIMA Lab SA) immunochromatographic assay. Some subjects underwent chemiluminescence immunoassay (CLIA) after rapid test. The aim of the study was to analyse the proportion of those who developed a positive IgM/IgG response for SARS-CoV-2. The correspondence between the results from rapid testing and CLIA, when available, was evaluated. 97 subjects underwent qPCR for SARS-CoV-2 through nasal swab, which resulted positive in 40/43 (93.0%) of symptomatic patients, 2/40 (5%) of asymptomatic HCW, in no subjects with suspected COVID- 19 (clinical and radiological findings) then excluded by repeated nasal swabs and alternative diagnosis (COVID-19-negative patients, CNPs), and in 6/6 (100%) of patients with confirmed diagnosis and negative follow-up nasal swabs (COVID-19-recovered patients, CRPs). IgM resulted positive in 8/43 (18.6%) of symptomatic patients and in 1/6 (16.7%) of CRPs. IgG resulted positive in 36/43 (83.7%) of symptomatic patients, 2/40 (5%) of HCW, and in 1/8 (12.5%) and 6/6 (100%) of CNPs and CRPs, respectively. A comparison between an IgG/IgM Rapid Test and a following CLIA test showed consistency in negative results in 25/28 of HCW and 8/8 of CNPs tested. Our preliminary data support the role of IgG/IgM Rapid Test (PRIMA Lab SA) immunochromatographic assay as a point-of-care test that may complement molecular tests in the screening of SARS-CoV-2 carriers. The test may gain particular relevance in shortening the time needed to refer patients to a COVID or non-COVID Hospital area and to achieve diagnosis in patients with persistently negative nasal swabs.
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Affiliation(s)
- Diana Canetti
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaele Dell'Acqua
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Liviana Della Torre
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alba Bigoloni
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | | | - Sara Racca
- Laboratory of Microbiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Italy
| | - Antonella Castagna
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Giuseppe Tambussi
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Adriano Lazzarin
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
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42
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Moura A, Nocerino P, Gilbertson JA, Rendell NB, Mangione PP, Verona G, Rowczenio D, Gillmore JD, Taylor GW, Bellotti V, Canetti D. Lysozyme amyloid: evidence for the W64R variant by proteomics in the absence of the wild type protein. Amyloid 2020; 27:206-207. [PMID: 32067519 PMCID: PMC7446029 DOI: 10.1080/13506129.2020.1720637] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Alexandra Moura
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Paola Nocerino
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Janet A Gilbertson
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Nigel B Rendell
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - P Patrizia Mangione
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK.,Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Guglielmo Verona
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Dorota Rowczenio
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Julian D Gillmore
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Graham W Taylor
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Vittorio Bellotti
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK.,Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Diana Canetti
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
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43
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Oltolini C, Guidetti A, Ripa M, Castiglioni B, Tassan Din C, Mastaglio S, Canetti D, Monti G, Andolina A, Molinari C, Poloniato A, Mastrangelo A, Ferrante M, Lanzillotta M, Scarpellini P, Castagna A, Corradini P, Ciceri F. Coronavirus Disease 2019 in Recipient of Allogeneic Hematopoietic Stem Cell Transplantation: Life-threating Features Within the Early Post-engraftment Phase. Hemasphere 2020; 4:e448. [PMID: 32885143 PMCID: PMC7430227 DOI: 10.1097/hs9.0000000000000448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/17/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Chiara Oltolini
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Anna Guidetti
- Hematology and Bone Marrow Transplant, Istituto Nazionale Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy
| | - Marco Ripa
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Barbara Castiglioni
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Tassan Din
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Sara Mastaglio
- Hematology and Bone Marrow Transplant, San Raffaele Scientific Institute, Milan, Italy
| | - Diana Canetti
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Monti
- Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Andolina
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Molinari
- Department of General Medicine, Endocrine and Metabolic Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Andrea Mastrangelo
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Marica Ferrante
- Department of General Medicine, San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Marco Lanzillotta
- Department of General Medicine, San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Paolo Scarpellini
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Paolo Corradini
- Hematology and Bone Marrow Transplant, Istituto Nazionale Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplant, San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
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44
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Castellotti P, Riccardi N, Ferrarese M, Canetti D, Fanti D, Forti E, Reda M, Alexiadis S, Bonoldi E, Saporiti M, Perno CF, Ruffo Codecasa L. Intestinal tuberculosis versus Inflammatory Bowel Diseases: a never-ending challenge. New Microbiol 2020; 43:139-143. [PMID: 32656568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 06/11/2023]
Abstract
Inflammatory Bowel Diseases (IBD) and intestinal tuberculosis (ITB) frequently share similar clinical, radiological, endoscopic and histologic features. The misdiagnosis of IBD can lead to worsening of ITB course, eventually with dissemination of Mycobacterium tuberculosis (MTB) due to immunosuppressive treatment. We herein report a challenging diagnosis of ITB, progressed from localized to disseminated, in a pregnant woman previously misdiagnosed with Crohn' disease (CD) on prolonged steroid treatment. Furthermore, we focus on three main issues: 1) the need for tuberculosis (TB) screening in pregnant women and in patients coming from TB endemic countries; 2) the effect of prolonged steroid treatment in misdiagnosed TB, particularly on its histological pattern; 3) the optimum clinical management of ITB.
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Affiliation(s)
- Paola Castellotti
- TB Reference Clinic and Laboratory, Villa Marelli Institute-Niguarda Hospital, Milan, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Niccolò Riccardi
- StopTB Italia Onlus, Milan, Italy
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maurizio Ferrarese
- TB Reference Clinic and Laboratory, Villa Marelli Institute-Niguarda Hospital, Milan, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Diana Canetti
- StopTB Italia Onlus, Milan, Italy
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Diana Fanti
- TB Reference Clinic and Laboratory, Villa Marelli Institute-Niguarda Hospital, Milan, Italy
| | - Edoardo Forti
- Gastroenterology Department, Niguarda Hospital, Milan, Italy
| | - Marco Reda
- Thoracic Surgery Department, Niguarda Hospital, Milan, Italy
| | | | | | - Matteo Saporiti
- TB Reference Clinic and Laboratory, Villa Marelli Institute-Niguarda Hospital, Milan, Italy
- StopTB Italia Onlus, Milan, Italy
| | - Carlo Federico Perno
- TB Reference Clinic and Laboratory, Villa Marelli Institute-Niguarda Hospital, Milan, Italy
| | - Luigi Ruffo Codecasa
- TB Reference Clinic and Laboratory, Villa Marelli Institute-Niguarda Hospital, Milan, Italy
- StopTB Italia Onlus, Milan, Italy
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45
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Canetti D, Rendell NB, Gilbertson JA, Botcher N, Nocerino P, Blanco A, Di Vagno L, Rowczenio D, Verona G, Mangione PP, Bellotti V, Hawkins PN, Gillmore JD, Taylor GW. Diagnostic amyloid proteomics: experience of the UK National Amyloidosis Centre. Clin Chem Lab Med 2020; 58:948-957. [PMID: 32069225 DOI: 10.1515/cclm-2019-1007] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/16/2020] [Indexed: 11/15/2022]
Abstract
Systemic amyloidosis is a serious disease which is caused when normal circulating proteins misfold and aggregate extracellularly as insoluble fibrillary deposits throughout the body. This commonly results in cardiac, renal and neurological damage. The tissue target, progression and outcome of the disease depends on the type of protein forming the fibril deposit, and its correct identification is central to determining therapy. Proteomics is now used routinely in our centre to type amyloid; over the past 7 years we have examined over 2000 clinical samples. Proteomics results are linked directly to our patient database using a simple algorithm to automatically highlight the most likely amyloidogenic protein. Whilst the approach has proved very successful, we have encountered a number of challenges, including poor sample recovery, limited enzymatic digestion, the presence of multiple amyloidogenic proteins and the identification of pathogenic variants. Our proteomics procedures and approaches to resolving difficult issues are outlined.
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Affiliation(s)
- Diana Canetti
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Nigel B Rendell
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Janet A Gilbertson
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Nicola Botcher
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Paola Nocerino
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Angel Blanco
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Lucia Di Vagno
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Dorota Rowczenio
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Guglielmo Verona
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - P Patrizia Mangione
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK.,Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Vittorio Bellotti
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK.,Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Philip N Hawkins
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Julian D Gillmore
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Graham W Taylor
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
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46
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Raimondi S, Mangione PP, Verona G, Canetti D, Nocerino P, Marchese L, Piccarducci R, Mondani V, Faravelli G, Taylor GW, Gillmore JD, Corazza A, Pepys MB, Giorgetti S, Bellotti V. Comparative study of the stabilities of synthetic in vitro and natural ex vivo transthyretin amyloid fibrils. J Biol Chem 2020; 295:11379-11387. [PMID: 32571879 DOI: 10.1074/jbc.ra120.014026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/17/2020] [Indexed: 01/18/2023] Open
Abstract
Systemic amyloidosis caused by extracellular deposition of insoluble fibrils derived from the pathological aggregation of circulating proteins, such as transthyretin, is a severe and usually fatal condition. Elucidation of the molecular pathogenic mechanism of the disease and discovery of effective therapies still represents a challenging medical issue. The in vitro preparation of amyloid fibrils that exhibit structural and biochemical properties closely similar to those of natural fibrils is central to improving our understanding of the biophysical basis of amyloid formation in vivo and may offer an important tool for drug discovery. Here, we compared the morphology and thermodynamic stability of natural transthyretin fibrils with those of fibrils generated in vitro either using the common acidification procedure or primed by limited selective cleavage by plasmin. The free energies for fibril formation were -12.36, -8.10, and -10.61 kcal mol-1, respectively. The fibrils generated via plasmin cleavage were more stable than those prepared at low pH and were thermodynamically and morphologically similar to natural fibrils extracted from human amyloidotic tissue. Determination of thermodynamic stability is an important tool that is complementary to other methods of structural comparison between ex vivo fibrils and fibrils generated in vitro Our finding that fibrils created via an in vitro amyloidogenic pathway are structurally similar to ex vivo human amyloid fibrils does not necessarily establish that the fibrillogenic pathway is the same for both, but it narrows the current knowledge gap between in vitro models and in vivo pathophysiology.
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Affiliation(s)
- Sara Raimondi
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - P Patrizia Mangione
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy.,Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
| | - Guglielmo Verona
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
| | - Diana Canetti
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
| | - Paola Nocerino
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
| | - Loredana Marchese
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Rebecca Piccarducci
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom.,Department of Pharmacy, University of Pisa, Pisa, Italy
| | - Valentina Mondani
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy.,Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
| | - Giulia Faravelli
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Graham W Taylor
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
| | - Julian D Gillmore
- National Amyloidosis Centre, University College London and Royal Free Hospital, London, United Kingdom
| | - Alessandra Corazza
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom.,Department of Medicine (DAME), University of Udine, Udine, Italy.,Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
| | - Mark B Pepys
- Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom.,National Amyloidosis Centre, University College London and Royal Free Hospital, London, United Kingdom
| | - Sofia Giorgetti
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy .,Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
| | - Vittorio Bellotti
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy .,Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, United Kingdom
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47
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Villa S, Riccardi N, Canetti D, Alagna R, Castellotti P, Ferrarese M, Cirillo D, Barberis I, Bragazzi NL, Gazzaniga V, Ricucci V, Codecasa LR, Besozzi G, Martini M. From the past, a long way to future challenges for a greater control of tuberculosis. Tuberculosis (Edinb) 2020; 123:101948. [PMID: 32741532 DOI: 10.1016/j.tube.2020.101948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/15/2020] [Accepted: 05/10/2020] [Indexed: 02/06/2023]
Abstract
Tuberculosis (TB) and humans have coexisted for more than 40,000 years; however TB remains a global threat to human kind. The international community has developed new tools for early detection, but TB strains evolved acquiring resistance to first-line therapeutic drugs with increasing treatment challenges. Furthermore, TB has formed also an alliance with human immunodeficiency virus; in this way the poorest populations are most affected. The current vaccine planning activity includes 14 new vaccines against TB (11 of those in the phaseII/III) developed with different techniques. Now, more than ever, new anti-TB drugs and new anti-TB regimens are urgently required as well as universal health care and social protection in order to tackle down both hard to treat TB and the social determinants of TB. Coordinated actions and sharing of information are needed to aspire everywhere to the best clinical practices and improve quality of life of patients and their families.
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Affiliation(s)
| | - Niccolò Riccardi
- StopTB Italia Onlus, Milan, Italy; Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Diana Canetti
- StopTB Italia Onlus, Milan, Italy; Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Riccardo Alagna
- StopTB Italia Onlus, Milan, Italy; Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Castellotti
- StopTB Italia Onlus, Milan, Italy; Regional TB Reference Centre, Villa Marelli Institute/ASST Niguarda Ca' Granda, Milan, Italy
| | - Maurizio Ferrarese
- StopTB Italia Onlus, Milan, Italy; Regional TB Reference Centre, Villa Marelli Institute/ASST Niguarda Ca' Granda, Milan, Italy
| | - Daniela Cirillo
- StopTB Italia Onlus, Milan, Italy; Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ilaria Barberis
- StopTB Italia Onlus, Milan, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Valentina Gazzaniga
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | | | - Luigi Ruffo Codecasa
- StopTB Italia Onlus, Milan, Italy; Regional TB Reference Centre, Villa Marelli Institute/ASST Niguarda Ca' Granda, Milan, Italy
| | | | - Mariano Martini
- StopTB Italia Onlus, Milan, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy.
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48
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Cavalli G, De Luca G, Campochiaro C, Della-Torre E, Ripa M, Canetti D, Oltolini C, Castiglioni B, Tassan Din C, Boffini N, Tomelleri A, Farina N, Ruggeri A, Rovere-Querini P, Di Lucca G, Martinenghi S, Scotti R, Tresoldi M, Ciceri F, Landoni G, Zangrillo A, Scarpellini P, Dagna L. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol 2020; 2:e325-e331. [PMID: 32501454 PMCID: PMC7252085 DOI: 10.1016/s2665-9913(20)30127-2] [Citation(s) in RCA: 693] [Impact Index Per Article: 173.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Mortality of patients with coronavirus disease 2019 (COVID-19), acute respiratory distress syndrome (ARDS), and systemic inflammation is high. In areas of pandemic outbreak, the number of patients can exceed maximum capacity of intensive care units (ICUs), and, thus, these individuals often receive non-invasive ventilation outside of the ICU. Effective treatments for this population are needed urgently. Anakinra is a recombinant interleukin-1 receptor antagonist that might be beneficial in this patient population. METHODS We conducted a retrospective cohort study at the San Raffaele Hospital in Milan, Italy. We included consecutive patients (aged ≥18 years) with COVID-19, moderate-to-severe ARDS, and hyperinflammation (defined as serum C-reactive protein ≥100 mg/L, ferritin ≥900 ng/mL, or both) who were managed with non-invasive ventilation outside of the ICU and who received standard treatment of 200 mg hydroxychloroquine twice a day orally and 400 mg lopinavir with 100 mg ritonavir twice a day orally. We compared survival, mechanical ventilation-free survival, changes in C-reactive protein, respiratory function, and clinical status in a cohort of patients who received additional treatment with anakinra (either 5 mg/kg twice a day intravenously [high dose] or 100 mg twice a day subcutaneously [low dose]) with a retrospective cohort of patients who did not receive anakinra (referred to as the standard treatment group). All outcomes were assessed at 21 days. This study is part of the COVID-19 Biobank study, which is registered with ClinicalTrials.gov, NCT04318366. FINDINGS Between March 17 and March 27, 2020, 29 patients received high-dose intravenous anakinra, non-invasive ventilation, and standard treatment. Between March 10 and March 17, 2020, 16 patients received non-invasive ventilation and standard treatment only and comprised the comparison group for this study. A further seven patients received low-dose subcutaneous anakinra in addition to non-invasive ventilation and standard treatment; however, anakinra treatment was interrupted after 7 days because of a paucity of effects on serum C-reactive protein and clinical status. At 21 days, treatment with high-dose anakinra was associated with reductions in serum C-reactive protein and progressive improvements in respiratory function in 21 (72%) of 29 patients; five (17%) patients were on mechanical ventilation and three (10%) died. In the standard treatment group, eight (50%) of 16 patients showed respiratory improvement at 21 days; one (6%) patient was on mechanical ventilation and seven (44%) died. At 21 days, survival was 90% in the high-dose anakinra group and 56% in the standard treatment group (p=0·009). Mechanical ventilation-free survival was 72% in the anakinra group versus 50% in the standard treatment group (p=0·15). Bacteraemia occurred in four (14%) of 29 patients receiving high-dose anakinra and two (13%) of 16 patients receiving standard treatment. Discontinuation of anakinra was not followed by inflammatory relapses. INTERPRETATION In this retrospective cohort study of patients with COVID-19 and ARDS managed with non-invasive ventilation outside of the ICU, treatment with high-dose anakinra was safe and associated with clinical improvement in 72% of patients. Confirmation of efficacy will require controlled trials. FUNDING None.
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Affiliation(s)
- Giulio Cavalli
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuel Della-Torre
- Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Ripa
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Diana Canetti
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Oltolini
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Barbara Castiglioni
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Tassan Din
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Boffini
- Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Tomelleri
- Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Farina
- Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Annalisa Ruggeri
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milan, Italy
- Internal Medicine, Diabetes, and Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe Di Lucca
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sabina Martinenghi
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaella Scotti
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Moreno Tresoldi
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Vita-Salute San Raffaele University, Milan, Italy
- Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University, Milan, Italy
- Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Scarpellini
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Riccardi N, Giacomelli A, Canetti D, Comelli A, Intini E, Gaiera G, Diaw MM, Udwadia Z, Besozzi G, Codecasa L, Biagio AD. Clofazimine: an old drug for never-ending diseases. Future Microbiol 2020; 15:557-566. [PMID: 32476494 DOI: 10.2217/fmb-2019-0231] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Clofazimine (CFZ), an old hydrophobic riminophenazine, has a wide range of antimycobacterial activity ranging from leprosy to nontuberculous mycobacterial diseases. CFZ has several advantages such as a favorable pharmacokinetic profile, dose-dependent side effects as well as low price. In this narrative review, we have assessed the clinical development of CFZ, starting from the potential in vitro mechanism of actions, to the spectrum of side effects and potential drug-drug interactions, highlighting its current place in therapy and future possible use in leprosy, nontuberculous mycobacterial diseases and drug-resistant tuberculosis.
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Affiliation(s)
- Niccolò Riccardi
- Department of Infectious, Tropical Diseases & Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.,StopTB Italia Onlus, Milan, Italy
| | - Andrea Giacomelli
- StopTB Italia Onlus, Milan, Italy.,III Infectious Diseases Unit, ASST Fatebenefratelli Sacco, Milano, Italy.,Department of Biomedical & Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Italy
| | - Diana Canetti
- StopTB Italia Onlus, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Agnese Comelli
- Department of Infectious & Tropical Diseases, Spedali Civili, Brescia, Italy
| | - Enrica Intini
- StopTB Italia Onlus, Milan, Italy.,Division of Respiratory Medicine, A. Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Giovanni Gaiera
- Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mama M Diaw
- StopTB Italia Onlus, Milan, Italy.,Médecin coordonnateur lutte contre la TB, Région médicale de Thiès, Thiès, Sénégal
| | - Zarir Udwadia
- Department of Pulmonary Medicine, PD. Hinduja National Hospital & Medical Research Centre, Mumbai, Maharashtra, India
| | | | - Luigi Codecasa
- StopTB Italia Onlus, Milan, Italy.,Regional TB Reference Centre & Laboratory, Villa Marelli Institute/ASST Niguarda Ca' Granda, Milan, Italy
| | - Antonio Di Biagio
- StopTB Italia Onlus, Milan, Italy.,Clinic of Infectious Diseases, IRCCS AOU San Martino-IST, Genoa, Italy
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50
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Zecca A, Barili V, Canetti D, Regina V, Olivani A, Carone C, Capizzuto V, Zerbato B, Trenti T, Dalla Valle R, Ferrari C, Cariani E, Missale G. Energy metabolism and cell motility defect in NK-cells from patients with hepatocellular carcinoma. Cancer Immunol Immunother 2020; 69:1589-1603. [PMID: 32307580 DOI: 10.1007/s00262-020-02561-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 04/01/2020] [Indexed: 02/07/2023]
Abstract
Functional rescue of NK-cells in solid tumors represents a central aim for new immunotherapeutic strategies. We have conducted a genomic, phenotypic and functional analysis of circulating NK-cells from patients with HCV-related liver cirrhosis and hepatocellular carcinoma. NK-cells were sorted from patients with HCC or liver cirrhosis and from healthy donors. Comparative mRNA gene expression profiling by whole-human-genome microarrays of sorted NK-cells was followed by phenotypic and functional characterization. To further identify possible mediators of NK-cell dysfunction, an in vitro model using media conditioned with patients' and controls' plasma was set up. Metabolic and cell motility defects were identified at the genomic level. Dysregulated gene expression profile has been translated into reduced cytokine production and degranulation despite a prevalent phenotype of terminally differentiated NK-cells. NKG2D-downregulation, high SMAD2 phosphorylation and other phenotypic and molecular alterations suggested TGF-β as possible mediator of this dysfunction. Blocking TGF-β could partially restore functional defects of NK-cells from healthy donors, exposed to TGF-β rich HCC patients' plasma, suggesting that TGF-β among other molecules may represent a suitable target for immunotherapeutic intervention aimed at NK-cell functional restoration. By an unbiased approach, we have identified energy metabolism and cell motility defects of circulating NK-cells as main mechanisms responsible for functional NK-cell impairment in patients with hepatocellular carcinoma. This opens the way to test different approaches to restore NK-cell response in these patients.
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Affiliation(s)
- Alessandra Zecca
- Laboratory of Viral Immunopathology, Unit of Infectious Diseases and Hepatology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Valeria Barili
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Diana Canetti
- Laboratory of Viral Immunopathology, Unit of Infectious Diseases and Hepatology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Valeria Regina
- Laboratory of Viral Immunopathology, Unit of Infectious Diseases and Hepatology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Andrea Olivani
- Laboratory of Viral Immunopathology, Unit of Infectious Diseases and Hepatology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Chiara Carone
- Toxicology and Advanced Diagnostics, Ospedale S. Agostino-Estense, Modena, Italy
| | - Valentina Capizzuto
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Barbara Zerbato
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Tommaso Trenti
- Toxicology and Advanced Diagnostics, Ospedale S. Agostino-Estense, Modena, Italy
| | - Raffaele Dalla Valle
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Carlo Ferrari
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Elisabetta Cariani
- Toxicology and Advanced Diagnostics, Ospedale S. Agostino-Estense, Modena, Italy
| | - Gabriele Missale
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy.
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